Frankel Allan, Gardner Roxane, Maynard Laura, Kelly Andrea
Partners Healthcare, Boston, USA.
Jt Comm J Qual Patient Saf. 2007 Sep;33(9):549-58. doi: 10.1016/s1553-7250(07)33059-6.
Patient safety administrators, educators, and researchers are striving to understand how best to monitor and improve team skills and determine what approaches to monitoring best suit their organizations. A behavior-based tool, based on principles of crisis resource management (CRM) in nonmedical industries, was developed to quantitatively assess communication and team skills of health care providers in a variety of real and simulated clinical settings.
The Communication and Teamwork Skills (CATS) Assessment has been developed through rapid-cycle improvement and piloted through observation of videotaped simulated clinical scenarios, realtime surgical procedures, and multidisciplinary rounds. Specific behavior markers are clustered into four categories-coordination, cooperation, situational awareness, and communication. Teams are scored in terms of the occurrence and quality of the behaviors. The CATS Assessment results enable clinicians to view a spectrum of scores-from the overall score for the categories to specific behaviors.
The CATS Assessment tool requires statistical validation and further study to determine if it reliably quantifies health care team performance. The patient safety community is invited to use and improve behavior-based observation measures to better evaluate their training programs, continue to research and improve observation methodology, and provide quantifiable, objective feedback to their clinicians and organizations.
患者安全管理人员、教育工作者和研究人员正在努力了解如何以最佳方式监测和提升团队技能,并确定哪种监测方法最适合他们的组织。一种基于非医疗行业危机资源管理(CRM)原则的行为工具被开发出来,用于在各种真实和模拟临床环境中定量评估医疗服务提供者的沟通和团队技能。
沟通与团队合作技能(CATS)评估是通过快速循环改进而开发的,并通过观察录像模拟临床场景、实时手术过程和多学科查房进行了试点。特定行为标记被归为四类——协调、合作、态势感知和沟通。团队根据行为的发生情况和质量进行评分。CATS评估结果使临床医生能够查看一系列分数——从类别总分到特定行为的分数。
CATS评估工具需要进行统计验证和进一步研究,以确定它是否能可靠地量化医疗团队的表现。邀请患者安全领域的人士使用并改进基于行为的观察措施,以更好地评估他们的培训项目,继续研究和改进观察方法,并向他们的临床医生和组织提供可量化、客观的反馈。